不问所病或温或凉或热或寒。如春时有疾，于所用药内加清凉之药。夏月有疾，加大寒
之药。秋月有疾，加温气之药。冬月有疾，加大热之药。是不绝生化之源也。内经曰∶“必
先岁气，无伐天和，是为至治”；又曰∶“无违时，无伐化”。又曰∶“无伐生生之气，此皆常
道用药之法。”若反其常道而变生异症，则当从权施治。
仲景云∶锉如麻豆大，与 咀同意。夫 咀者，古之制也。古无铁刃，以口咬细，令如
麻豆，为粗药煎之。使药水清饮于腹中，则易升易散也，此所谓 咀也。今人以刀器锉如麻
豆大，此 咀之易成也。若一概为细末，不厘清浊矣。经云∶清阳发腠理，浊阴走五脏，果
何谓也。又曰∶清阳实四肢，浊阴归六腑，是也。 咀之法，取汁清易循行经络故也。若治
至高之病加酒煎，去湿加生姜煎，补元气以大枣煎，发散风寒以葱白煎，去膈上病以蜜煎。
散者，细末也，不循经络止去膈上病及脏腑之病。气味浓者，白汤调服。气味薄者，煎以和
渣服。去下部之疾，其丸极大而光且圆，治中焦者次之，治上焦者则极小，稠糊面丸者，取
其迟化直至下焦。或酒或醋丸者，取其收散之意也。用半夏、南星或去湿者，以生姜汁煮糊
为丸，制其毒也。稀糊丸者，取其易化也。水浸一宿，蒸饼为丸，及滴水为丸者，皆取易化
也。炼蜜为丸者，取其迟化而气循经络也。用蜡为丸者，取其难化而旋旋收功也。大抵汤者
荡也，去久病者用之。散者散也，去急病者用之。丸者缓也，不能速去其病，用药徐缓而治
之也。
不论疾病性质是温、凉、热还是寒。如果春季患病，在所用药物中加入清凉性质的药。夏季患病，加入大寒性质的药。秋季患病，加入温气性质的药。冬季患病，加入大热性质的药。这是为了不断绝生命化生的源头。《黄帝内经》说：“必须首先考虑当年的气候特点，不要破坏人体与自然和谐的状态，这才是最高明的治疗”；又说：“不要违背时令，不要破坏自然的化育规律”。还说：“不要伤害生生不息的气机”，这些都是常规用药的方法。如果违背这些常规而改变治法导致出现异常病症，就应当权宜变通进行治疗。
张仲景说：将药材切碎如麻子或豆子大小，这与“咀”的意思相同。“咀”是古代的做法。古代没有铁制刀具，用口咬碎药材，使其像麻子或豆子一样大小，作为粗药煎煮。这样使药液清澈，服用后容易升发和散开，这就是所谓的“咀”。现在的人用刀器等工具将药材锉碎成麻豆大小，这是“咀”的简便做法。如果一律磨成细粉，就不能分辨清浊了。医经说：清阳之气发散于腠理（皮肤肌肉之间的间隙），浊阴之气走注于五脏，这是什么意思呢？又说：清阳之气充实四肢，浊阴之气归入六腑，就是这个道理。“咀”这种炮制方法，是为了取得清澈的药汁，使其容易在经络中循行。如果是治疗身体上部的高位疾病，加酒煎煮；祛湿加生姜煎煮；补元气加大枣煎煮；发散风寒加葱白煎煮；去除膈膜以上的疾病加蜂蜜煎煮。散剂，就是细粉末，不循行经络，只用于去除膈膜以上的疾病及脏腑的疾病。气味浓厚的，用白开水调服。气味淡薄的，煎煮后连同药渣一起服用。治疗下部的疾病，丸药做得极大且光洁圆润；治疗中焦疾病的次之；治疗上焦疾病的则极小。用稠糊面制作的丸药，取其消化缓慢，能直达下焦。或用酒或醋制作丸药，取其收敛或发散之意。使用半夏、天南星或需要祛湿的药物时，用生姜汁煮糊来制作丸药，以制约其毒性。稀糊丸，取其容易消化的特性。用水浸泡一夜，蒸饼为丸，以及滴水为丸，都是取其容易消化的特性。炼蜜为丸，取其消化缓慢且药气能循行经络的特性。用蜡制作丸药，取其难以消化从而慢慢发挥疗效的特性。大体上说，汤剂的作用是涤荡，用于治疗久病。散剂的作用是消散，用于治疗急病。丸剂的作用是缓和，不能迅速去除疾病，是用药徐缓地治疗它。
Regardless of whether the disease is characterized by warmth, coolness, heat, or cold. If illness occurs in spring, add cooling herbs to the prescribed formula. If illness occurs in summer, add herbs with great cold properties. If illness occurs in autumn, add herbs with warm qi properties. If illness occurs in winter, add herbs with great heat properties. This ensures that the source of biological generation is not cut off. The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "One must first consider the annual climate qi, and not disrupt the harmony between heaven and humanity; this is the highest form of treatment." It also states: "Do not violate the seasons, do not disrupt natural transformation." And again: "Do not damage the vital qi of life." These are all standard methods of medication usage. If one violates these standard principles and alters the treatment, leading to atypical symptoms, then one should exercise discretion and adapt the treatment accordingly.
Zhang Zhongjing said: "Crush the herbs to the size of hemp seeds or beans; this is consistent with the meaning of 'ju' (chewing/grinding). 'Ju' is an ancient method. In ancient times, there were no iron blades, so herbs were bitten finely by mouth until they resembled hemp seeds or beans, used as coarse herbs for decoction. This makes the medicinal liquid clear, allowing it to ascend and disperse easily when taken into the abdomen; this is what is meant by 'ju'. Nowadays, people use knives and tools to crush herbs to the size of hemp seeds or beans; this is the simplified version of 'ju'. If all herbs are ground into fine powder, the distinction between clear and turbid substances would be lost. The classics state: 'Clear yang qi disperses to the couli (interstices of skin and muscle), while turbid yin qi travels to the five zang organs.' What does this mean? It further states: 'Clear yang qi fills the four limbs, while turbid yin qi returns to the six fu organs.' This is correct. The method of 'ju' is employed to obtain a clear decoction, facilitating its circulation through the meridians. For diseases located high in the body, add wine for decoction; for dampness, add fresh ginger for decoction; to tonify primordial qi, add jujube for decoction; to dispel wind-cold, add scallion white for decoction; for diseases above the diaphragm, add honey for decoction. San (powders) refer to fine powders; they do not circulate through the meridians but are used only for diseases above the diaphragm and within the zang-fu organs. Herbs with strong flavors and aromas are taken with plain boiled water. Herbs with weak flavors and aromas are decocted and taken with the dregs. For diseases in the lower part of the body, pills are made very large, smooth, and round; for diseases in the middle jiao, they are smaller; for diseases in the upper jiao, they are extremely small. Pills made with thick paste flour are intended to digest slowly, reaching the lower jiao directly. Pills made with wine or vinegar are intended to achieve either astringent or dispersing effects. When using Banxia (Pinelliae Rhizoma) or Nanting (Arisaematis Rhizoma), or for dampness removal, ginger juice is used to cook the paste for making pills, to mitigate their toxicity. Xi hu wan (thin paste pills) are intended for easy digestion. Soaked in water overnight, formed into pills with steamed bread dough, or dropped into water to form pills, all aim for easy digestion. Pills made with refined honey aim for slow digestion and the circulation of medicinal qi through the meridians. Pills made with wax aim for difficult digestion, thereby achieving gradual therapeutic effects. Generally speaking, Tang (decoctions) act by sweeping away pathogens, used for chronic diseases. San (powders) act by dispersing, used for acute diseases. Wan (pills) act by缓 (slowing/relaxing); they cannot quickly eliminate disease but treat it gradually and gently.